Anticipated ethical questions and responses to the COVID- 19 pandemic
| Question | Value | Response |
|---|---|---|
| Are the restrictions on normal activities ethically justified? | At risk: Individual liberty (integrity/empathy) Overriding value: Public health responsibilities (quality and safety/community) | Yes. Restrictions that impinge on individual liberty should be applied equitably when relevant and necessary to protect the public from serious harm. Personal and professional practices must be regularly reviewed and amended for the duration of the pandemic to assure fairness of application. |
| How much more restrictive can the measures ethically be for individuals and communities? | At risk: Justice and autonomy (caregiver/empathy) Overriding value: Protection of the public from harm (safety/community) | In a public health crisis, healthcare organizations and public health authorities may be required to implement restrictions. Reasoning for the restrictions should be based on those minimally necessary to protect the public/individuals from the harm of infection-transmission. |
| I don't want anyone to know I have COVID-19. Is it a HIPPA violation to report my diagnosis to public health officials? | At risk: Privacy/integrity Overriding value: Obligations to our patients' health | Not necessarily. In a public health crisis, the right to privacy typically afforded individuals may be overridden to protect the public from serious harm. Restrictions are the minimum necessary to accomplish public health goal with full transparency to patients. |
| Who has the greatest right to personal protective equipment? | At risk: Protection of all employees and community Overriding value: Duty to provide care | Healthcare workers have a duty to care for the sick even when this places them at greater risk of harm. To mitigate these elevated risks, healthcare workers should be prioritized when distributing personal protective equipment. |
| How will public health officials and healthcare leaders decide how to distribute the resources if supplies become scarce? | At risk: Providing each patient what they need.( Overriding values: Stewardship/utility/transparency | The distribution of testing and treatment will be equitable and measured by the expectation of benefit. During a pandemic, the parameters for distribution of scarce goods may shift to a focus on rescue of the sick who are expected to recover. |
| What can the public expect regarding updates and communication about how healthcare institutions will make decisions? | At risk: Expending time and resources Overriding value: Open and transparent | Decisions should be made using an open and transparent process that is accessible to the public. The basis for procedural and allocation decisions will be based on evidence, principles, and shared values. |